Individual
MS. ANNA RUSSAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2051 MARENGO ST, LOS ANGELES, CA 90033-1352
(323) 409-1000
Mailing address
1983 MARENGO ST, LOS ANGELES, CA 90033-1370
(323) 409-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95025812
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95025812
CA
Other
Enumeration date
10/12/2023
Last updated
01/18/2024
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